Proton pump inhibition

Dosing: Adult

Active duodenal ulcer: Oral: 20 mg once daily for 4-8 weeks

Gastric ulcers: Oral: 40 mg once daily for 4-8 weeks

Symptomatic GERD (without esophageal lesions): Oral: 20 mg once daily for up to 4 weeks

Erosive esophagitis: Oral: 20 mg once daily for 4-8 weeks; maintenance of healing: 20 mg once daily for up to 12 months total therapy (including treatment period of 4-8 weeks)

Helicobacter pylori eradication: Oral: Dose varies with regimen:

Manufacturer labeling: 40 mg once daily administered with clarithromycin 500 mg 3 times/day for 14 days or 20 mg twice daily administered with amoxicillin 1000 mg and clarithromycin 500 mg twice daily for 10 days. Note: Presence of ulcer at time of therapy initiation may necessitate an additional 14-18 days of omeprazole 20 mg/day (monotherapy) after completion of combination therapy.

American College of Gastroenterology guidelines (Chey, 2007):

Nonpenicillin allergy: 20 mg twice daily administered with amoxicillin 1000 mg and clarithromycin 500 mg twice daily for 10-14 days

Penicillin allergy: 20 mg twice daily administered with clarithromycin 500 mg and metronidazole 500 mg twice daily for 10-14 days or 20 mg once or twice daily administered with bismuth subsalicylate 525 mg and metronidazole 250 mg plus tetracycline 500 mg 4 times/day for 10-14 days

Pathological hypersecretory conditions: Oral: Initial: 60 mg once daily; doses up to 120 mg 3 times/day have been administered; administer daily doses >80 mg in divided doses

Stress-ulcer prophylaxis (ICU patients; unlabeled use): Oral: 40 mg once daily; periodically evaluate patient for continued need (Levy, 1997)

Frequent heartburn (OTC labeling): Oral: 20 mg once daily for 14 days; treatment may be repeated after 4 months if needed

Dosing: Pediatric

GERD or other acid-related disorders: Oral: Children 1-16 years:

5 kg to <10 kg: 5 mg once daily

10 kg to <20 kg: 10 mg once daily

≥20 kg: 20 mg once daily

Dosing: Geriatric

Refer to adult dosing.

Dosing: Renal Impairment

No adjustment is necessary.

Dosing: Hepatic Impairment

Bioavailability is increased with chronic liver disease. Consider dosage adjustment, especially for maintenance of erosive esophagitis. Specific guidelines are not available